2022
                           DELAWARE                FORM
                           DIVISION OF REVENUE                       PIT-VCHPIT-VCH
                           ElEctronic FilEr PayMEnt VouchEr
                                    
                                                                                   RESET        PRINT

  YOUR TAXPAYER ID           SECONDARY TAXPAYER ID (if joint return)                 3. AMOUNT OF THE PAYMENT

1                          2                                                       3

  YOUR FIRST NAME            YOUR LAST NAME

4
  SECONDARY FIRST NAME       SECONDARY LAST NAME

5
  STREET ADDRESS
                                                                     Make your check or money order payable to 
                                                                                   “Delaware Division of Revenue”. 
                                                                                         Do not send cash.
6 CITY                       STATE ZIP CODE
                                                                     Mail completed form to:
                                                                                   Delaware Division of Revenue 
                                                                                            PO Box 830 
                                                                                   Wilmington, DE 19899-0830

  DO NOT CUT THIS PAGE

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